- Rates of obesity
are rising faster in rural areas than in urban areas disproving long-held perceptions about city life being associated with an
increased risk of obesity and other health issues
- Cities offer better and more options
for improving general health such as wider range of dietary options,
better infrastructure for physical exercise and relaxation and access to
better health care
- The findings of
the study suggest that fresh thinking and exploring newer ways to tackle
the global health problem of obesity is the need of the hour
are rising faster in rural areas than urban areas disproving
long-held perceptions about city life, reveals a recent study done by Imperial College, London, looking at global body
(BMI) trends. The findings of the study
appear in Nature.
Readily available patient data such as height and
weight are used to calculate body mass index
an internationally employed scale to determine whether an individual has a
healthy weight for their height. BMI categorizes a person as
underweight, normal, overweight and obese based on the value.
Design of the Study
This UK study looked at the height and weight data of over 112 million adult men and women spread across rural and city areas in 200 countries between 1985 and 2017. The study involved a team of over 1000
scientists across the world and looked at the trends in both low and middle-income countries as well
as high-income countries.
‘Obesity rates are rising faster in rural areas than urban areas. Thats because cities offer more opportunities for improving general health such as better nutrition options, better infrastructure for physical exercise and relaxation as well as better health care. These are more difficult to find in rural areas and may contribute to the rising obesity rates.’
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Key Findings of the Study
results of this massive global study overturn commonly held perceptions that
more people living in cities is the main cause of the global rise in
- Between 1985 and 2017, BMI increased
worldwide by an average of 2.2 kg/m2 in men and 2.0
kg/m2 in women equivalent to each a 5-6 kilo increase in weight
- Average BMI increase in rural population was 2.1
kg/m2 in both women and men
- Average increase in urban areas
was 1.3 kg/m2 and 1.6 kg/m2 in women and men
- Interestingly, over 50% of the
increase in BMI was from rural areas.
- In some low- and middle-income
nations, rural areas accounted for nearly 80% of this increase
- In 1985 and before, adults living in
cities of over 75% of the countries had a higher BMI than their rural
counterparts. With time, this gap between city and rural population
narrowed or even reversed.
senior author Professor Majid Ezzati of Imperial's School of Public Health. "This means that we
need to rethink how we tackle this global health problem."
Rising BMI Trends in Developing Nations & The Developed World
areas in developing nations
have seen a change towards higher income, improved infrastructure for
health care as well as mechanized
agriculture and more buying of personal transport, all of which improve
quality of life, but also lead to lesser physical exercise, increased
spending on unhealthy junk food. These factors may have contributed to the
rising BMI in the rural population
in low and middle-income countries.
- In high-income countries,
the reason for increasing BMI since 1985 could be attributed to the
disadvantages experienced by those living in rural areas including fewer
dietary and healthy food options,
lower income and education,
and fewer options of sports and
- The major exception to the worldwide
BMI trend was sub-Saharan Africa where urban women gained weight faster
possibly due to a more sedentary lifestyle
such as desk jobs, access to unhealthy foods, motorized travel compared to
rural women who still need to walk a lot and expend more energy to obtain
domestic necessities such as firewood and fetching water.
& Regional Data on BMI Globally between 1985-2017
- BMI decreased slightly during the study period
among women in twelve countries, including
Europe (France, Italy, Malta, Portugal, Czech Republic, Greece, Spain,
Lithuania, and Serbia) and the Asia
Pacific (Japan, Nauru, Singapore).
- BMI increased by more than 5 kg/m2
in Egyptian and Honduran women.
- BMI increased in men in all countries,
the biggest increases were seen in
Saint Lucia, Bahrain, China, Peru, China, USA and the Dominican Republic,
all by over 3.1 kg/m2.
- Rural women in Bangladesh had the
lowest recorded BMI at 17.7 kg/m2 and rural men in Ethiopia had the lowest
male BMI at 18.4 kg/m2, both recorded in 1985.
- In 2017, both women and men in urban sub-Saharan
Africa were heavier than their rural counterparts
by a larger margin than anywhere else, particularly women in West
African countries like Burkina Faso, Niger, Ghana and Togo.
- Rural women in eastern and central
Europe weighed more than their city counterparts by the greatest margin -
about 1 kg/m2 or more in the Czech
Republic, Latvia and Belarus that has largely stayed unchanged since 1985.
- The biggest differences of rural
over urban BMI were found in the Czech
Republic, Sweden, Ireland, Australia, USA and Austria, all with rural BMI
over 0.35 kg/m2 more than their city counterparts.
of obesity are rising faster in rural compared to city areas in most countries
of the world with the exception of Sub-Saharan Africa, and health experts have
to explore newer ways to tackle this changing global trend of obesity and
increased BMI. References :
- Rising rural body-mass index is the main driver of the global obesity epidemic in adults - (http://dx.doi.org/10.1038/s41586-019-1171-x)